Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus‐related advanced fibrosis or cirrhosis
Background and Aim A subcirrhotic range of liver stiffness (sc‐LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc‐LS by antiviral therapy (AVT) reduced the risk of developing hepatocell...
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| Veröffentlicht in: | Journal of Gastroenterology and Hepatology Jg. 33; H. 2; S. 503 - 510 |
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| Sprache: | Englisch |
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Australia
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01.02.2018
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| Abstract | Background and Aim
A subcirrhotic range of liver stiffness (sc‐LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc‐LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB‐related advanced fibrosis or cirrhosis.
Methods
In total, 209 patients with CHB‐related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut‐off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa.
Results
The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc‐LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc‐LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc‐LS (log‐rank test, P = 0.020).
Conclusions
The achievement of sc‐LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT. |
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| AbstractList | Background and Aim A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis. Methods In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5-24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020). Conclusions The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT. A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis.BACKGROUND AND AIMA subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis.In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa.METHODSIn total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa.The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5-24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020).RESULTSThe median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5-24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020).The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.CONCLUSIONSThe achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT. Background and Aim A subcirrhotic range of liver stiffness (sc‐LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc‐LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB‐related advanced fibrosis or cirrhosis. Methods In total, 209 patients with CHB‐related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut‐off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc‐LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc‐LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc‐LS (log‐rank test, P = 0.020). Conclusions The achievement of sc‐LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT. A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis. In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5-24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020). The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT. |
| Author | Byung Seok Kim Jeong‐Ju Yoo Young Seok Kim Han Ah Lee Hyung Joon Yim Young Kul Jung Kwang‐Hyub Han Chang Hyeong Lee Sang Gyune Kim Soon Ho Um Yeon Seok Seo Sang Jun Suh Sang Hoon Ahn Seung Up Kim |
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| BackLink | https://cir.nii.ac.jp/crid/1870303265832942080$$DView record in CiNii https://www.ncbi.nlm.nih.gov/pubmed/28666070$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Han, Kwang Hyup Byung Seok Kim Jeong-Ju Yoo Young Seok Kim Kim, Seung Up Han Ah Lee Ahn, Sang Hoon Hyung Joon Yim Young Kul Jung Chang Hyeong Lee Sang Gyune Kim Soon Ho Um Dept. of Internal Medicine Yeon Seok Seo College of Medicine Kwang-Hyub Han Sang Jun Suh Sang Hoon Ahn Seung Up Kim |
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| Copyright | 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd |
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| Keywords | liver fibrosis hepatitis B liver stiffness transient elastography antiviral therapy cirrhosis hepatocellular carcinoma |
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A subcirrhotic range of liver stiffness (sc‐LS), assessed by transient elastography, is associated with better outcomes in patients with... A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B... Background and Aim A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with... |
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| SubjectTerms | Aged Antiviral Agents Antiviral Agents - therapeutic use antiviral therapy Carcinoma, Hepatocellular Carcinoma, Hepatocellular - etiology Carcinoma, Hepatocellular - prevention & control Chronic/complications/drug therapy Hepatitis B Cirrhosis Female Fibrosis Hepatitis Hepatitis B Hepatitis B, Chronic Hepatitis B, Chronic - complications Hepatitis B, Chronic - drug therapy Hepatocellular carcinoma Hepatocellular/etiology/prevention & control Carcinoma Humans Liver cancer Liver Cirrhosis Liver Cirrhosis - etiology liver fibrosis Liver Neoplasms Liver Neoplasms - etiology Liver Neoplasms - prevention & control Liver Neoplasms/etiology/prevention & control liver stiffness Male Middle Aged Multivariate analysis Population studies Risk transient elastography |
| Title | Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus‐related advanced fibrosis or cirrhosis |
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